MedWorm: Cholecystectomy

Sincalide Cholescintigraphy—32 Years Later: Evidence-Based Data on Its Clinical Utility and Infusion Methodology

Seminars in Nuclear Medicine — Fri, 03 Feb 2012 08:29:31 +0100

Sincalide cholescintigraphy was first reported to have clinical utility in 1980. Since then, many publications have found that a reduced gallbladder ejection fraction (GBEF) can confirm the clinical diagnosis of acalculous chronic gallbladder disease and predict symptomatic relief with cholecystectomy. However, some publications had not found the test clinically predictive. Many different sincalide infusion methods and normal values have been used. It had been suspected that the different infusion methods and normal values might account for the variability in reported utility. Furthermore, clinical review articles have raised questions about the evidence-based quality of the published data on the diagnostic utility of sincalide cholescintigraphy. A recently published multicenter trial has ...

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Meta‐analysis of one‐ vs. two‐stage laparoscopic/endoscopic management of common bile duct stones

HPB: official journal of the International Hepato Pancreat Biliary Association — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions: Outcomes after one‐stage laparoscopic/endoscopic management of bile duct stones are no different to the outcomes after two‐stage management. (Source: HPB: official journal of the International Hepato Pancreat Biliary Association)

Effect of Normal Saline Irrigation on Attenuation of Shoulder Tip Pain and on β-Endorphin Levels After Laparoscopic Cholecystectomy

Journal of Laparoendoscopic — Thu, 02 Feb 2012 04:11:02 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Commentary on “Are Natural Orifice Transluminal Endoscopic Surgery and Single-Incision Surgery Viable Techniques for Cholecystectomy?”

Journal of Laparoendoscopic — Wed, 01 Feb 2012 16:20:18 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques Jan 2012, Vol. 22, No. 1: 15-16. (Source: Journal of Laparoendoscopic)

Biliary stenting: Indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline

Endoscopy — Wed, 01 Feb 2012 05:00:00 +0100

This article is part of a combined publication that expresses the current view of the European Society of Gastrointestinal Endoscopy about endoscopic biliary stenting. The present Clinical Guideline describes short-term and long-term results of biliary stenting depending on indications and stent models; it makes recommendations on when, how, and with which stent to perform biliary drainage in most common clinical settings, including in patients with a potentially resectable malignant biliary obstruction and in those who require palliative drainage of common bile duct or hilar strictures. Treatment of benign conditions (strictures related to chronic pancreatitis, liver transplantation, or cholecystectomy, and leaks and failed biliary stone extraction) and management of complications (includ...

Short‐term electrical stimulation of the lower esophageal sphincter increases sphincter pressure in patients with gastroesophageal reflux disease

Neurogastroenterology and Motility — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions & Inferences Short‐term stimulation of the LES in patients with GERD significantly increases resting LESP without affecting esophageal peristalsis or LES relaxation. Electrical stimulation of the LES may offer a novel therapy for patients with GERD. (Source: Neurogastroenterology and Motility)

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ICG‐fluorescence identification of a small aberrant biliary canaliculus during robotic cholecystectomy

Liver International — Tue, 31 Jan 2012 05:00:00 +0100

(Source: Liver International)

Ascitic fluid due to type II herpes simplex virus infection: Report of a case with immunocytochemical confirmation

Diagnostic Cytopathology — Mon, 30 Jan 2012 06:31:20 +0100

This report highlights that the presence of abundant cell debris, degenerative cells and apoptotic bodies, and the absence of vivid mesothelial cells are the key cytological findings to suspect HSV peritonitis, and the diagnosis can be confirmed by careful surveillance for characteristic nuclear findings of single or multinucleated cells. The frequency of opportunistic infection is increased because of the increased numbers of iatrogenic immunocompromised patients as seen in this case, therefore, cytological examination is a useful method for early detection of the causative agent of peritonitis including HSV. Diagn. Cytopathol. 2011; © 2011 Wiley Periodicals, Inc. (Source: Diagnostic Cytopathology)

Predictors of pre‐transplant dropout and post‐transplant recurrence in patients with perihilar cholangiocarcinoma

Hepatology — Mon, 30 Jan 2012 05:00:00 +0100

Conclusion: Outcome following neoadjuvant chemoradiation and liver transplantation for perihilar CCA is excellent. Risk of dropout is related to patient and tumor characteristics and this can be used to guide patient counseling prior to enrolment. Recurrence risk is mostly associated with presence of residual cancer on explant. PSC patients do not have an independent survival advantage over de‐novo patients, but present with more favorable tumor characteristics. (HEPATOLOGY 2012.) (Source: Hepatology)

Technical description of a regional lymphadenectomy in radical surgery for gallbladder cancer

HPB: official journal of the International Hepato Pancreat Biliary Association — Sun, 29 Jan 2012 20:47:58 +0100

Conclusion: A systematic approach towards a regional lymphadenectomy ensures a consistent nodal harvest in patients undergoing radical resection for gallbladder cancer. (Source: HPB: official journal of the International Hepato Pancreat Biliary Association)

Laparoscopic Cholecystectomy Without Intraoperative Cholangiography

Journal of Laparoendoscopic — Sat, 28 Jan 2012 04:14:13 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

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Transumbilical laparoscopic surgery using GelPort through an umbilical zigzag skin incision

Asian Journal of Endoscopic Surgery — Fri, 27 Jan 2012 11:25:51 +0100

We report herein a new method of transumbilical laparoscopic surgery using a GelPort through an umbilical zigzag skin incision. The method involves collaborating with plastic surgeons to ensure the procedure was minimally invasive.Materials and Surgical TechniqueAfter marking a zigzag skin incision in the umbilical region, the skin was incised along this line. Then, a GelPort double‐ring wound retractor was inserted through the incision, which enlarged the diameter of the fascial opening to 6 cm. The Gelport was latched on the wound retractor ring, following the inflation of the pneumoperitoneum by CO2. One or more additional ports were inserted as necessary. All operations were performed in the standard fashion. The specimen was easily extracted from the abdomen through the umbilical ...

Carcinoma involving the gallbladder: A retrospective review of 23 cases - pitfalls in diagnosis of gallbladder carcinoma

Diagnostic Pathology — Fri, 27 Jan 2012 05:00:00 +0100

Conclusions: Clinical history and a high index of suspicion are prerequisite to detecting GBC. Detection of GBC at an early stage is difficult because the symptoms mimic benign gallbladder diseases. Misinterpretation of subtle microscopic abnormalities contributes diagnostic failures in early cases. Careful attention to any evidence of mural thickening, thorough sampling, particularly in older patients, and close examination of any deeply situated glandular structures are critical. Correlations with radiographic and clinical findings are important helps to avoid misdiagnosis in this commonly resected organ. (Source: Diagnostic Pathology)

Multivariable Analysis of Cholecystectomy after Gastrectomy: Laparoscopy is a Feasible Initial Approach even in the Presence of Common Bile Duct Stones or Acute Cholecystitis

World Journal of Surgery — Tue, 24 Jan 2012 07:55:19 +0100

Conclusions The laparoscopic approach is feasible for cholecystectomy after gastrectomy, even in cases with CBD stones or acute cholecystitis. This approach does not appear to increase operation time or complication rate and was shown to decrease the length of postoperative hospital stay. Content Type Journal ArticlePages 1-7DOI 10.1007/s00268-012-1429-zAuthors Joohyun Kim, Department of Surgery, School of Medicine, Kyung Hee University, 26 Kyunghee-daero, Dongdaemun-gu, Seoul, 130-701 KoreaJeong Nam Cho, Department of Surgery, School of Medicine, Kyung Hee University, 26 Kyunghee-daero, Dongdaemun-gu, Seoul, 130-701 KoreaSun Hyung Joo, Department of Surgery, School of Medicine, Kyung Hee University, 26 Kyunghee-daero, Dongdaemun-gu, Seoul, 130-701 KoreaBum Soo Kim,...

Effect of Genetic Variants Related to Lipid Metabolism as Risk Factors for Cholelithiasis After Bariatric Surgery in Brazilian Population

Obesity Surgery — Tue, 24 Jan 2012 06:50:12 +0100

Conclusions The CETP TaqIB and APOE HhaI polymorphisms do not seem to have association with gallstones in the late postoperative bariatric surgery, considering that these genetic variants do not differ subgroups of patients who are eligible to routine prophylactic cholecystectomy, at least in Brazilian population. Content Type Journal ArticleCategory Basic Science ResearchPages 1-11DOI 10.1007/s11695-012-0590-7Authors Sidney Pinheiro-Júnior, Department of Molecular Biology, Center for Biochemistry and Molecular Biology Research, São José do Rio Preto Medical School, 15090000 Av. Brigadeiro Faria Lima 5416, Vila São Pedro, São José do Rio Preto, São Paulo, BrazilMarcela A. S. Pinhel, Department of Molecular Biology, Center for Biochemistry and Molecular Biolog...

An Easier Way To Remove Gallstones

Health News from Medical News Today — Thu, 19 Jan 2012 09:00:00 +0100

For more than 100 years, the traditional treatment for the painful growths called gallstones has been removal of the gallbladder, or cholecystectomy. But a new device, patented in China, promises to make removing the entire organ unnecessary. A group of scientists from the Second People's Hospital of Panyu District and Central South University in China have developed an endoscope specially designed for locating and clearing out gallstones and other gallbladder lesions. The authors describe the device in a paper accepted to the AIP's Review of Scientific Instruments... (Source: Health News from Medical News Today)

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The effect of perioperative psychological intervention on fatigue after laparoscopic cholecystectomy: a randomized controlled trial

Surgical Endoscopy — Thu, 19 Jan 2012 08:04:53 +0100

Conclusion This was the first interventional study targeting fatigue after laparoscopic cholecystectomy by using a brief psychological relaxation intervention. It has shown a reduction of fatigue and impact of fatigue at 30 days postoperatively in the intervention group. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-011-2101-7Authors Arman Kahokehr, Department of Surgery, South Auckland Clinical School, Middlemore Hospital, University of Auckland, P.O. Box 93311, Otahuhu, Auckland, New ZealandElizabeth Broadbent, Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New ZealandBenjamin R. L. Wheeler, Department of Surgery, South Auckland Clinical School, Middlemore Hospital, ...

Modular acute system for general surgery: hand over the operation, not the patient

ANZ Journal of Surgery — Thu, 19 Jan 2012 05:00:00 +0100

Conclusion: This study describes an efficient and safe system for providing acute general surgical care in a high‐volume setting with satisfactory clinical outcomes. It is compatible with the GSA 12‐point plan. (Source: ANZ Journal of Surgery)

Reference standard for serum bile acids in pregnancy.

BJOG : An International Journal of Obstetrics and Gynaecology — Wed, 18 Jan 2012 05:00:00 +0100

Conclusions SBA values in uncomplicated pregnancies are consistent, regardless of gestation, and are not elevated in pregnancy. The current reference values for the diagnosis of OC appear to be appropriate. PMID: 22251417 [PubMed - as supplied by publisher] (Source: BJOG : An International Journal of Obstetrics and Gynaecology)

Laparoscopic or open cholecystectomy in cirrhosis: a systematic review of outcomes and meta‐analysis of randomized trials

HPB: official journal of the International Hepato Pancreat Biliary Association — Wed, 18 Jan 2012 05:00:00 +0100

Conclusions: There are few RCTs comparing OC and LC in patients with cirrhosis. These studies are small, heterogeneous in design and include almost exclusively patients with Child–Pugh class A and B disease. However, LC appears to be associated with shorter operative time, reduced complication rates and reduced length of hospital stay. (Source: HPB: official journal of the International Hepato Pancreat Biliary Association)

Reference standard for serum bile acids in pregnancy

BJOG: An International Journal of Obstetrics and Gynaecology — Wed, 18 Jan 2012 05:00:00 +0100

Conclusions SBA values in uncomplicated pregnancies are consistent, regardless of gestation, and are not elevated in pregnancy. The current reference values for the diagnosis of OC appear to be appropriate. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

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Payer Status and Treatment Paradigm for Acute Cholecystitis [Original Article]

Archives of Surgery — Mon, 16 Jan 2012 05:00:00 +0100

Conclusions Medicaid payer status confers inferior access to surgical treatment for AC. While this finding may be due in part to patients' health beliefs and physician preferences, the magnitude of difference suggests that health systems factors may provide a significant contribution toward clinical decision making in this entity. (Source: Archives of Surgery)

Impact of uremic environment on peritoneum: A proteomic view.

Journal of Proteomics — Mon, 16 Jan 2012 05:00:00 +0100

Authors: Wang HY, Lin CY, Chien CC, Kan WC, Tian YF, Liao PC, Wu HY, Su SB Abstract Peritoneal morphology and function are abnormal in uremia patients, but the contributing mechanisms are unclear. Here we attempted to characterize the protein targets that may be related to peritoneal change in patients with uremia and have not exposed to peritoneal dialysis fluid. Protein profiles of peritoneal fluids collected from patients with uremia and patients with normal renal function receiving laparoscopic cholecystectomy were displayed by two-dimensional gel electrophoresis (2-DE). Altered protein spots were excised and subjected to tryptic digestion followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. Sixteen 2-DE protein spots were altered between two groups. ...

General Anaesthesia for Laparoscopic Cholecystectomy in a Patient with the Kearns-Sayre Syndrome

Journal of Biomedicine and Biotechnology — Sun, 15 Jan 2012 16:11:39 +0100

We report a case of a 40-year-old man affected by the Kearns-Sayre syndrome who underwent an elective laparoscopic cholecystectomy under general anaesthesia. We describe the management of general anaesthesia in this rare myopathy, with emphasis on the use of rocuronium as muscle blocking agent. Induction was achieved with propofol and fentanyl, and general anaesthesia was maintained with fentanyl and sevoflurane/N2O/O2 mixture. The anaesthetic plan proved to be safe and effective, and extubation was achieved in the operating theatre. The postoperative recovery of the patient was satisfactory and uneventful. (Source: Journal of Biomedicine and Biotechnology)

Single-Port and Four Port Laparoscopic Cholecystectomy: Difference in Outcomes

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:07 +0100

(Source: Journal of Surgical Research)

Emergent Cholecystectomy is Superior to Open Cholecystectomy in Extremely Ill Patients with Acute Acalculous Cholecystitis: A Large Multi-center Outcome Study

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:07 +0100

(Source: Journal of Surgical Research)

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Novel Technique for Gallbladder Retraction During Single, Incision Cholecystectomy: Initial Experience

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:48 +0100

Conclusions: In this initial experience, the use of this novel retraction device demonstrated to be reliable, safe and easy to use. the retraction device allows the surgeon to perform the cholecystectomy within acceptable operative time, and no added complications. the advantages of this new device are that it is versatile, reusable, reduces the number of incisions, and is re-adjustable. in addition, more retractors can be added if necessary. the adaptability of this novel device will potentially broaden the range of procedures that can be performed through a single-incision. (Source: Journal of Surgical Research)

The Financial Burden of Training Surgical Residents: Who Should Bear the Cost?

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:47 +0100

This report analyses costs associated with five commonly performed surgical procedures with and without surgical resident assistance. 7146 surgical procedures performed between May 2004 and February 2011 were analyzed. Data pertaining to operative time, type surgery (open or laparoscopic), and training level of residents, if any, were abstracted. Two major groups and 11 procedure related subcategories were formed. Attending only (AO) cases did not involve residents, whereas cases designated as AR, involved attendings and residents. the difference in the operative times between these groups coupled with the hospital OR charges per minute of time ($15/min after the initial 30 minutes) was used to calculate the additional cost of care. the impact of resident training level on OR time was asse...

Show Me the Money: Cost Comparison of Virtual Reality Versus Immersive Part Task Laparoscopic Cholecystectomy Simulation-Based Training

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:47 +0100

Conclusions: Although the initial upfront cost for a VR machine is high, SBT using it can cost less compared to less expensive PT models due to disposable costs. the costs for both forms of SBT, however, are minimal compared to those related to biliary injury during laparoscopic CCY. Residents found both SBT formats equally relevant to their development as surgeons. (Source: Journal of Surgical Research)

An Objective System for Measuring Surgical Complexity in Elderly Patients

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:02 +0100

Conclusions: This pilot study demonstrates that clinical data from ACS NSQIP can be used to assess surgical complexity. the CRS provides a single index value, reflecting both severity and likelihood of adverse outcomes that allows objective comparisons of the surgical risk across procedure groups. the work RVU does not strongly correlate with the CRS. the CRS more strongly correlated to the surgeons' rankings of procedures compared to the work RVU. in the next phase, the CRS will be refined based on surveys from a larger group of surgeons. (Source: Journal of Surgical Research)

Cost-Comparison Analysis of Cholecystectomy During Bariatric Surgery

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:55 +0100

(Source: Journal of Surgical Research)

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The Impact of Resident Involvement on Patient Outcomes During Elective Inguinal Hernia Repair and Laparoscopic Cholecystectomy: An Analysis of Over 50,000 Cases from the ACS-NSQIP

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:54 +0100

(Source: Journal of Surgical Research)

Single incision laparoscopic cholecystectomy: A review on the complications

Journal of Minimal Access Surgery — Fri, 13 Jan 2012 05:00:00 +0100

Conclusion: Although the number of complications after single incision laparoscopic cholecystectomy seems favourable, it is too early to conclude that single incision laparoscopic cholecystectomy is a safe procedure. Large randomised controlled trials will be necessary to further establish its safety. (Source: Journal of Minimal Access Surgery)

The barrier-free trocar technique in three laparoscopic standard procedures

Journal of Minimal Access Surgery — Fri, 13 Jan 2012 05:00:00 +0100

Conclusion : Laparoscopic standard procedures are feasible using this barrier-free trocar without a higher degree of difficulty. Because of the facilitated instrumentation, it is possible to work more efficiently and to maintain the focus on the surgical field. (Source: Journal of Minimal Access Surgery)

Safe Cholecystectomy A-Z

Journal of Minimal Access Surgery — Fri, 13 Jan 2012 05:00:00 +0100

Tehemton E UdwadiaJournal of Minimal Access Surgery 2012 8(1):27-27 (Source: Journal of Minimal Access Surgery)

Gallstones and cholecystectomy in relation to risk of intra- and extrahepatic cholangiocarcinoma

British Journal of Cancer AOP — Thu, 12 Jan 2012 05:00:00 +0100

Authors: H Nordenstedt, F Mattsson, H El-Serag & J Lagergren (Source: British Journal of Cancer AOP)

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Acute cholecystitis in high risk surgical patients: percutaneous cholecystostomy versus laparoscopic cholecystectomy (CHOCOLATE Trial): Study protocol for a randomized controlled trial.

Trials — Thu, 12 Jan 2012 05:00:00 +0100

DiscussionThe CHOCOLATE trial is designed to provide the surgical community with an evidence based guideline in the treatment of acute calculous cholecystitis in high risk patients. (Source: Trials)

Report of Four Simultaneous Pancreas–Kidney Transplants in HIV‐Positive Recipients with Favorable Outcomes

American Journal of Transplantation — Thu, 05 Jan 2012 05:00:00 +0100

The advent of combined antiretroviral therapy (cART) dramatically changed the view of human immunodeficiency virus (HIV) infection as an exclusion criterion for solid organ transplantation, resulting in worldwide reports of successful transplants in HIV‐infected individuals. However, there are few reports on simultaneous pancreas–kidney transplant in HIV‐positive recipients detailing poor outcomes. A series of four pancreas–kidney transplant performed on HIV‐infected individuals between 2006 and 2009 is presented. All recipients reached stably undetectable HIV‐RNA after transplantation. All patients experienced early posttransplant infections (median day 30, range 9–128) with urinary tract infections and bacteremia being most commonly observed. In all cases, surgical complica...

What is the Duct of Luschka?—A Systematic Review

Journal of Gastrointestinal Surgery — Wed, 04 Jan 2012 07:01:52 +0100

Conclusions The term “ducts of Luschka” should be abandoned and should be replaced by the correct term of “subvesical bile duct”. The variability in anatomic location of subvesical bile ducts puts them at risk during hepato-biliary operations. A better understanding of ductal anatomy is elemental in preventing and managing operative injury to the subvesical ducts. This review debunks common myths about the so-called “duct of Luschka” and offers a systematic overview of the anatomy of the subvesical bile duct. Content Type Journal ArticleCategory Review ArticlePages 1-7DOI 10.1007/s11605-011-1802-5Authors Thomas Schnelldorfer, Department of Surgery, University of Pennsylvania School of Medicine, 4 Silverstein, 3400 Spruce Street, Philadelphia, PA 19104, ...

Early phase detection of bile leak after hepatobiliary surgery: value of Gd-EOB-DTPA-enhanced MR cholangiography

Abdominal Imaging — Mon, 02 Jan 2012 16:54:19 +0100

Conclusions Gd-EOB-DTPA-enhanced MR cholangiography is a highly reliable technique for the detection of bile leaks after hepatobiliary surgery and may avoid the use of other, potentially risky invasive diagnostic techniques. Content Type Journal ArticlePages 1-8DOI 10.1007/s00261-011-9834-6Authors Alvaro Alegre Castellanos, Radiodiagnosis and Imaging Service, Hospital Universitario Reina Sofía, Avenida de Menéndez Pidal s/n, 14004 Cordoba, SpainJuan Felix Molina Granados, Unidad Central de Radiodiagnóstico de la Comunidad de Madrid, Hospital del Sureste, Arganda del Rey, Madrid, SpainJose Escribano Fernandez, Radiodiagnosis and Imaging Service, Hospital Universitario Reina Sofía, Avenida de Menéndez Pidal s/n, 14004 Cordoba, SpainInmaculada Gallardo Muñoz, Radi...

Evaluation of the effects of a preoperative 2-hour fast with maltodextrine and glutamine on insulin resistance, acute-phase response, nitrogen balance, and serum glutathione after laparoscopic cholecystectomy: a controlled randomized trial.

JPEN Journal Of Parenteral And Enteral Nutrition — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions: Preoperative intake of a GLN-enriched CHO beverage appears to improve IR and antioxidant defenses and decreases the inflammatory response after video-cholecystectomy. PMID: 22235107 [PubMed - in process] (Source: JPEN Journal Of Parenteral And Enteral Nutrition)

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Laparoscopic double cholecystectomy

ANZ Journal of Surgery — Sun, 01 Jan 2012 05:00:00 +0100

(Source: ANZ Journal of Surgery)

Clinical Characteristics and Risk Factors for Symptomatic Pediatric Gallbladder Disease

PEDIATRICS — Fri, 30 Dec 2011 05:00:00 +0100

Gallbladder disease in children is an evolving entity and studies suggest an increasing frequency of symptomatic pediatric gallbladder disease and resultant cholecystectomies. Hispanic ethnicity and obesity are epidemiologically significant risk factors for symptomatic gallbladder disease in the pediatric population. (Read the full article) (Source: PEDIATRICS)

Percutaneous versus endoscopic approach in treatment of acute cholecystitis

Gastrointestinal Endoscopy — Wed, 28 Dec 2011 12:50:19 +0100

To the Editor: I have read with great interest the article by Jang et al, which evaluates the technical feasibility and safety of EUS-guided transgastric/transduodenal gallbladder drainage with single-step placement of a modified covered self-expandable metal stent in patients with acute cholecystitis who are unsuitable for cholecystectomy. The authors concluded that this method could be a feasible and safe alternative to treatments such as percutaneous cholecystostomy (PC) in patients with acute cholecystitis who were unsuitable for cholecystectomy. (Source: Gastrointestinal Endoscopy)

Response

Gastrointestinal Endoscopy — Wed, 28 Dec 2011 12:50:19 +0100

We would like to thank Dr Enver Zerem for his insightful editorial to our article. We would like to provide some additional perspective on his commentary. To treat acute cholecystitis, percutaneous catheter drainage is now the definitive treatment for patients who are not candidates for cholecystectomy. Percutaneous catheter drainage also can be a time-saving bridge treatment for preoperative preparation of and stabilization of high-risk operative patients. However, for patients with limited life expectancy because of advanced malignancy—not in healthy people—external catheter use is an unwelcome treatment because of catheter-related pain, bile bag management, and cosmetic problems that reduce quality of life. The frequent recurrence of cholecystitis following catheter removal also is...

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Changes of the sphincter of Oddi motility in dog after cholecystectomy

Chinese Journal of Digestive Diseases — Thu, 22 Dec 2011 09:24:51 +0100

CONCLUSIONS: Shortly after a cholecystectomy in Beagle dogs, the CBD pressure increased, SO motilities did not change significantly during the interdigestive phase except with a shortened cycle duration. Its relaxation responded to CCK was weakened with a confused contraction pattern. (Source: Chinese Journal of Digestive Diseases)

Use of Cholecystostomy Tubes in the Management of Patients with Primary Diagnosis of Acute Cholecystitis

Journal of the American College of Surgeons — Thu, 22 Dec 2011 05:00:00 +0100

Conclusions: This 9-year experience shows that use of CCT in complicated AC can be a desirable alternative to open cholecystectomy that allows most patients to subsequently undergo LC. Additional studies are underway to determine the differences in cost, training paradigms, and quality of life in this increasingly high-risk surgical population. (Source: Journal of the American College of Surgeons)

Cholecystectomy Concomitant with Laparoscopic Gastric Bypass: A Trend Analysis of the Nationwide Inpatient Sample from 2001 to 2008

Obesity Surgery — Tue, 20 Dec 2011 06:42:53 +0100

Conclusions Concomitant cholecystectomy and laparoscopic gastric bypass surgery have decreased significantly over the last decade. Given the higher rates of postoperative complications, reinterventions, mortality, as well as longer hospital stay, concomitant cholecystectomy should only be considered in patients with symptomatic gallbladder disease. Content Type Journal ArticleCategory Clinical ResearchPages 1-10DOI 10.1007/s11695-011-0575-yAuthors Mathias Worni, Research on Research Group, Department of Surgery, Duke University Medical Center, DUMC 3094, Durham, NC 27710, USAUlrich Guller, Department of Visceral Surgery and Medicine, University of Bern, Bern, SwitzerlandAnand Shah, Research on Research Group, Department of Surgery, Duke University Medical Center, DU...

Systematic review of intraoperative cholangiography in cholecystectomy

British Journal of Surgery — Mon, 19 Dec 2011 23:03:15 +0100

Conclusion:There is no robust evidence to support or abandon the use of IOC to prevent retained CBD stones or bile duct injury. Level 1 evidence for IOC is of poor to moderate quality. None of the trials, alone or in combination, was sufficiently powered to demonstrate a benefit of IOC. Further small trials cannot be recommended. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

Influence of demographic factors, basic blood test parameters and opioid type on propofol pharmacokldnetics and pharmacodynamics in ASA I-III patients.

Arzneimittel-Forschung — Mon, 19 Dec 2011 07:30:02 +0100

Authors: Bienert A, Wiczling P, Zaba C, Zaba Z, Wolc A, Marciniak R, Grześkowiak E, Kusza K Abstract The aim of the study was to examine population pharmacokinetics (PK) and pharmacodynamics (PD) of propofol (CAS 2078-54-8) during total intravenous anesthesia monitored by spectral frequency index (SFx). Twenty-eight patients of ASA physical status I-III (ASA: American Society of Anesthesiologists) scheduled for laparoscopic cholecystectomy were included. In group I an anesthesia was induced with a bolus of propofol (2 mg/kg) and remifentanil (CAS 132875-61-7) (1.0 microg/kg), followed by a continuous infusion of remifentanil. In group II, an alfentanil (CAS 71195-58-9) (10 microg/kg) bolus dose was followed by a continuous infusion of alfentanil. The general anesthetic technique i...

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Raising The Thinker: New Concept for Dissecting the Cystic Pedicle During Laparoscopic Cholecystectomy [Resident's Forum]

Archives of Surgery — Mon, 19 Dec 2011 05:00:00 +0100

Imprecise dissection due to poor visualization of anatomic structures is among the major causes of biliary injuries during laparoscopic cholecystectomy. Developing new illustrational and rendering techniques represents an important part in decreasing visual deception and subsequent bile duct injuries. We use the model of one of the most well-known pieces of art, Rodin's The Thinker, to visualize the gallbladder and cystic pedicle structures. This minimizes visual deception before dissection, especially in cases with obscured structures. Our method, raising The Thinker, is based on the remarkable similarity between the sculpture and the topographic anatomy of the gallbladder. The method can be used not only for better orientation and visualization during laparoscopic cholecystectomy but als...

Single-port laparoscopic hepatectomy: technique, safety, and feasibility in a clinical case series

Surgical Endoscopy — Sat, 17 Dec 2011 06:43:58 +0100

Conclusion The SLH technique is a safe and feasible procedure for a specific group of candidates, including patients with high-grade liver dysfunction. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-011-2095-1Authors Masayasu Aikawa, Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298 JapanMitsuo Miyazawa, Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298 JapanKojun Okamoto, Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298 JapanYasuko Toshimitsu, Department of Surgery, Gast...

Single-site robotic cholecystectomy (SSRC) versus single-incision laparoscopic cholecystectomy (SILC): comparison of learning curves. First European experience

Surgical Endoscopy — Sat, 17 Dec 2011 06:43:48 +0100

Conclusions Our preliminary experience shows that SSRC is safe, can easily be learned, and performed in a reproducible manner and is faster than SILC. Content Type Journal ArticlePages 1-8DOI 10.1007/s00464-011-2087-1Authors Giuseppe Spinoglio, Department of Surgery, SS Antonio e Biagio Hospital, 16 Via Venezia, 15121 Alessandria AL, ItalyLuca Matteo Lenti, Department of Surgery, SS Antonio e Biagio Hospital, 16 Via Venezia, 15121 Alessandria AL, ItalyValeria Maglione, Department of Surgery, SS Antonio e Biagio Hospital, 16 Via Venezia, 15121 Alessandria AL, ItalyFrancesco Saverio Lucido, Department of Surgery, SS Antonio e Biagio Hospital, 16 Via Venezia, 15121 Alessandria AL, ItalyFabio Priora, Department of Surgery, SS Antonio e Biagio Hospital, 16 Via Venezia, 15...

3D HD versus 2D HD: surgical task efficiency in standardised phantom tasks

Surgical Endoscopy — Sat, 17 Dec 2011 06:43:44 +0100

Conclusions This study shows that 3D HD using a state-of-the-art 3D monitor permits superior task efficiency, even as compared with the latest 2D HD video systems. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-011-2055-9Authors Pirmin Storz, Department of General, Visceral and Transplant Surgery, Workgroup Experimental Minimally Invasive Surgery and Training, University Hospital Tuebingen, Waldhoernlestrasse 22, 72072 Tuebingen, GermanyGerhard F. Buess, Department of General, Visceral and Transplant Surgery, Workgroup Experimental Minimally Invasive Surgery and Training, University Hospital Tuebingen, Waldhoernlestrasse 22, 72072 Tuebingen, GermanyWolfgang Kunert, Department of General, Visceral and Transplant Surgery, Workgroup Experimental Minimally Invas...

Single-incision laparoscopic surgery (SILS) vs. conventional multiport cholecystectomy: systematic review and meta-analysis

Surgical Endoscopy — Fri, 16 Dec 2011 06:52:51 +0100

Conclusion The results of this meta-analysis demonstrate that single-incision laparoscopic cholecystectomy is a safe procedure for the treatment of uncomplicated gallstone disease, with postoperative outcome similar to that of standard multiport laparoscopic cholecystectomy. Future high-powered randomized studies should be focused on elucidating subtle differences in postoperative complications, reported postoperative pain, and cosmesis following SILS cholecystectomy in more severe biliary disease. Content Type Journal ArticleCategory ReviewPages 1-9DOI 10.1007/s00464-011-2051-0Authors S. R. Markar, Academic Surgical Unit, St. Mary’s Hospital, 10th Floor, Praed Street, London, W2 1NY UKA. Karthikesalingam, Department of General Surgery, St. George’s Hospital, L...

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Single-incision laparoscopic cholecystectomy with routine intraoperative cholangiography and common bile duct exploration via the umbilical port

Surgical Endoscopy — Thu, 15 Dec 2011 06:44:15 +0100

Conclusions This study represents the largest series to date of single-incision laparoscopic cholecystectomies with routine IOC via the umbilical port and is the first study to demonstrate that the laparoscopic management of choledocholithiasis during SILC is feasible. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-011-2009-2Authors David Yeo, Department of Upper Gastrointestinal Surgery, Royal Prince Alfred Hospital Sydney, Sydney, AustraliaSean Mackay, Department of Upper Gastrointestinal Surgery, Box Hill Hospital Melbourne, Melbourne, AustraliaDavid Martin, Department of Upper Gastrointestinal Surgery, Royal Prince Alfred and Concord Hospitals Sydney, Sydney, Australia Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794 (Source: ...

Neuroendocrine Carcinoma of the Stomach: A Case Study

EURASIP Journal on Bioinformatics and Systems Biology — Wed, 14 Dec 2011 17:08:27 +0100

Gastric neuroendocrine carcinomas are rare and have a poor prognosis, and the diagnostic criteria for this disease have recently changed. We herein report a case of sporadic gastric neuroendocrine carcinoma. A 75-year-old man was referred to our hospital with epigastric pain. Endoscopic examination revealed a localized ulcerative lesion (diameter, 4 cm) at the upper stomach. The diagnosis on biopsy was neuroendocrine carcinoma. Total gastrectomy with D2 lymphadenectomy, splenectomy, and cholecystectomy was performed. Pathologically, the tumor infiltrated the subserosal layer, and 6/49 lymph nodes were involved. The tumor was uniform in shape and arranged in a rosette-like structure to form solid nests, with medium-sized, round-to-cuboid-shaped tumor cells and intense mitosis 46/10 H...

Selected medical conditions and risk of pancreatic cancer

Molecular Carcinogenesis — Wed, 14 Dec 2011 11:13:15 +0100

AbstractWe review the current evidence for associations of several medical conditions with risk of pancreatic cancer, including allergies, pancreatitis, gall bladder disease, cholecystectomy, ulcers, gastrectomy, appendectomy, and tonsillectomy. There are consistent findings of reduced risk associated with presence of self‐reported allergies, particularly hay fever but not asthma; data on other allergies are limited and inconclusive. Several studies provide evidence that patients with pancreatic cancer are more likely than comparison groups to report pancreatitis. Those studies that investigated the time between onset of pancreatitis and diagnosis of pancreatic cancer found that risk estimates declined with longer periods of time; however, increased risks were noted for long‐term pancr...

Gallbladder cancer: Can newer insights improve the outcome?

Journal of Gastroenterology and Hepatology — Wed, 14 Dec 2011 05:00:00 +0100

ABSTRACTGallbladder cancer (GBC) is the leading cause of cancer related mortality in certain geographic areas. Most of the patients with GBC have advanced disease at presentation, precluding curative resection resulting in a dismal prognosis. However, recent advances in the understanding of its epidemiology and pathogenesis coupled with development of newer diagnostic tools and therapeutic options, has resulted in enhanced optimism towards the management of the disease.The leading risk factors are gallstones, advancing age, female gender, anomalous pancreaticobiliary ductal junction, certain ethnic groups and geographic populations. Advances in radiological imaging and advent of endoscopic ultrasound have facilitated early detection and accurate staging of the tumor. A high index of suspic...

Objective Assessment of Laparoscopic Skills: Dual-Task Approach.

Surgical Innovation — Tue, 13 Dec 2011 05:00:00 +0100

Conclusions. The use of dual-task methodology may help trainers to identify which surgical trainees require more preparation before entering the real operating room environment. Expert surgeons are capable of maintaining performance levels on a primary task in the face of distractions that may occur in the operating room. PMID: 22170894 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

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Intuitive Surgical Announces New Single-Site(TM) Instrumentation for the da Vinci(R) Si(TM) Surgical System

Medical News (via PRIMEZONE) — Tue, 13 Dec 2011 02:15:00 +0100

SUNNYVALE, Calif., Dec. 12, 2011 (GLOBE NEWSWIRE) -- Intuitive Surgical, Inc. (Nasdaq:ISRG), the global leader in minimally invasive robotic-assisted surgery, today announced that it received FDA clearance to market its Single-Site Instrumentation for laparoscopic cholecystectomy procedures, the surgical removal of the gall bladder. (Source: Medical News (via PRIMEZONE))

True left-sided gallbladder with a portal anomaly: report of a case

Surgery Today — Fri, 09 Dec 2011 06:50:14 +0100

Abstract A 65-year-old female who presented with back pain was diagnosed to have the presence of biliary sludge in the gallbladder. Computed tomography showed that the round ligament connected to the left portal umbilical portion was in the normal anatomical position. However, the gallbladder was located to the left of the middle hepatic vein and the round ligament, attached to the left lateral segment of the liver. The right posterior portal vein diverged alone from the main portal vein, and there was a long stem from the right anterior and left portal veins. Laparoscopic cholecystectomy confirmed the abnormal location of the gallbladder. Most reported cases of left-sided gallbladder are caused by a right-sided round ligament, which is called a “false” left-sided gall...

A Novel Retraction Instrument Improves the Safety of Single-Incision Laparoscopic Cholecystectomy in an Animal Model

Journal of Laparoendoscopic — Fri, 09 Dec 2011 04:16:42 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

The Effects of a Small Dose of Dexamethasone on Cell Adhesion Molecules during Laparoscopic Cholecystectomy

Drugs in R — Wed, 07 Dec 2011 07:01:54 +0100

This article is currently available as a free download on ingentaconnect (Source: Drugs in R)

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Health-related quality of life outcomes after cholecystectomy.

World Journal of Gastroenterology — Wed, 07 Dec 2011 05:00:00 +0100

Authors: Carraro A, Mazloum DE, Bihl F Abstract Gallbladder diseases are very common in developed countries. Complicated gallstone disease represents the most frequent of biliary disorders for which surgery is regularly advocated. As regards, cholecystectomy represents a common abdominal surgical intervention; it can be performed as either an elective intervention or emergency surgery, in the case of gangrene, perforation, peritonitis or sepsis. Nowadays, the laparoscopic approach is preferred over open laparotomy. Globally, numerous cholecystectomies are performed daily; however, little evidence exists regarding assessment of post-surgical quality of life (QOL) following these interventions. To assess post-cholecystectomy QOL, in fact, documentation of high quality care has been s...

Comparison of Cosmetic Outcome Between Single-Incision Laparoscopic Cholecystectomy and Conventional Laparoscopic Cholecystectomy: An Objective Study

Journal of Laparoendoscopic — Tue, 06 Dec 2011 21:31:18 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Cholecystectomy in the Very Elderly—Is 90 the New 70?

Journal of Gastrointestinal Surgery — Tue, 06 Dec 2011 07:00:52 +0100

Conclusion Our study demonstrates that in unselected nonagenarians,cholecystectomy is safe with acceptable perioperative morbidity and mortality even as an emergency procedure. However, our data also suggests that cholecystitis appears to be a neglected condition in this age group. Content Type Journal ArticleCategory 2011 SSAT Poster PresentationPages 1-4DOI 10.1007/s11605-011-1708-2Authors Attila Dubecz, Department of Surgery, Klinikum Nürnberg, Nuremberg, GermanyMiriam Langer, Department of Surgery, Klinikum Nürnberg, Nuremberg, GermanyRudolf J. Stadlhuber, Department of Surgery, Klinikum Nürnberg, Nuremberg, GermanyMichael Schweigert, Department of Surgery, Klinikum Nürnberg, Nuremberg, GermanyNorbert Solymosi, Hungarian Academy of Sciences–Corvinus Univer...

Analgesic Concentrations of Oxycodone – a Prospective Clinical PK/PD Study in Patients with Laparoscopic Cholecystectomy

Basic and Clinical Pharmacology and Toxicology — Sun, 04 Dec 2011 05:00:00 +0100

In conclusion, the estimated MEC, 20‐35 ng/mL, and MEAC, 45‐50 ng/mL, values of P‐oxycodone in patients after laparoscopic cholecystectomy were significantly higher than those proposed previously. Early pain after LCC appeared to be a feasible method to estimate the analgesic efficacy of oxycodone in acute pain management. (Source: Basic and Clinical Pharmacology and Toxicology)

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Transvaginal NOTES Hybrid Cholecystectomy.

Surgical Innovation — Sun, 04 Dec 2011 05:00:00 +0100

Conclusion. TVC is a safe, feasible, and attractive alternative to traditional 4-port laparoscopic cholecystectomy. PMID: 22143750 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

Opioid-free single-incision laparoscopic (SIL) cholecystectomy using bilateral TAP blocks

Journal of Clinical Anesthesia — Fri, 02 Dec 2011 05:00:00 +0100

Abstract: A 30 year old woman who was 8 weeks postpartum with a history of cholelithiasis and gallstone pancreatitis, and who was status-post endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy, was treated with a single-incision laparoscopic (SIL) cholecystectomy. A transversus abdominis plane block (TAP) was performed after induction of anesthesia. The patient required no intraoperative or postoperative opioids. (Source: Journal of Clinical Anesthesia)

Are Natural Orifice Transluminal Endoscopic Surgery and Single-Incision Surgery Viable Techniques for Cholecystectomy?

Journal of Laparoendoscopic — Fri, 02 Dec 2011 04:16:10 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Primary sclerosing cholangitis and malignancy

Best Practice and Research. Clinical Gastroenterology — Thu, 01 Dec 2011 05:00:00 +0100

Cholangiocarcinoma complicates primary sclerosing cholangitis (PSC) in approximately 10% of cases, but no risk factor that can identify this subgroup of patients is known. No imaging modalities or serum tumour markers that can diagnose early cholangiocarcinoma are available, but endoscopic retrograde cholangiography with brush cytology is recommended when clinically indicated. Liver transplantation with neoadjuvant therapy is carried out in specialist centres in cases of limited stage cancer. Transplantation should also be considered in patients with biliary dysplasia without evident tumour. Gallbladder polyps in PSC are often malignant, and liberal indication for cholecystectomy is recommended. Hepatocellular carcinoma develops in 2%–4% of patients with end-stage liver disease. Patients...

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Anatomy of the gallbladder and bile ducts

Surgery (Medicine Publishing) — Thu, 01 Dec 2011 05:00:00 +0100

Abstract: A detailed knowledge of the gallbladder and bile ducts (together with their anatomical variations) and related blood supply are essential in the safe performance of both open and laparoscopic cholecystectomy as well as the interpretation of radiological and ultrasound images of these structures. These topics are described and illustrated. (Source: Surgery (Medicine Publishing))

Gallstones

Surgery (Medicine Publishing) — Thu, 01 Dec 2011 05:00:00 +0100

Abstract: Gallstones represent one of the commonest surgical problems in the developed world. Post-mortem studies have found gallstones in 12% of men and 24% of women of all ages. Gallstones may be symptomatic or found incidentally. Symptoms arise due to stones in the gallbladder, in the bile duct, or both. It is estimated that 10–30% of patients with gallstones develop symptoms, of which a majority eventually require endoscopic or surgical intervention. Complications of gallstone disease include acute cholecystitis, obstructive jaundice, acute pancreatitis, gangrene of the gallbladder and gallstone ileus. Laparoscopic cholecystectomy is currently the treatment of choice for symptomatic gallstone disease and common bile duct stones can be treated surgically or at endoscopic retrograde ch...

Contemporary management of bile duct injuries

Surgery (Medicine Publishing) — Thu, 01 Dec 2011 05:00:00 +0100

Abstract: Laparoscopic cholecystectomy is the standard of care for symptomatic cholelithiasis, but it is associated with a higher incidence of bile duct injury (BDI) than the open approach. BDI can lead to mortality, significant morbidity and impaired quality of life. Immediate management of BDI recognized during cholecystectomy depends on the type of injury, the condition of the patient, and the experience of the surgeon. For patients presenting after cholecystectomy with a bile duct injury, the priority should be accurate assessment of the type of injury and early repair if possible; however for patients presenting after 2 weeks with established sepsis, it may be preferable to wait to allow appropriate control of sepsis and plan for definitive biliary reconstruction after 3 months. Proxi...

Single-incision laparoscopic cholecystectomy: from four wounds to one.

Hong Kong Med J — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSION. Single-incision laparoscopic cholecystectomy is feasible and safe for treatment of uncomplicated gallbladder diseases. There was a reduction in the operating time and increase in success rate with accumulation of experience. Nevertheless, surgeons should be cautious about the potential risks of this new technique. PMID: 22147316 [PubMed - in process] (Source: Hong Kong Med J)

Single-site incision laparoscopic cholecystectomy in children: a single-center initial experience

Journal of Pediatric Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Abstract: Laparoscopic cholecystectomy is the standard approach in most pediatric surgical centers. In an attempt to further minimize the surgical trauma and improve cosmetic outcome, new techniques with a single incision through the umbilicus have been proposed. There are still few reports concerning this technique in the pediatric population. We evaluated the feasibility of the single incision for laparoscopic cholecystectomy in children. We performed the operation in 10 patients, with a mean age of 12 years, mean operating time of 122 minutes, and mean hospital stay of 2 days. No complications occurred, and no conversion to open surgery was needed. In 1 patient, an extra 5-mm port was necessary. The cosmetic results were very satisfactory. In our experience, despite its technical diffic...

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Morbidity of appendectomy and cholecystectomy in pregnant and nonpregnant women.

Obstetrics and Gynecology — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSION: : Pregnancy does not increase the occurrence of postoperative maternal morbidity related to appendectomy and cholecystectomy. LEVEL OF EVIDENCE: : II. PMID: 22105255 [PubMed - in process] (Source: Obstetrics and Gynecology)

Laparoscopic Cholecystectomy Without Handling the Cystic Artery: A New Approach to Minimize Complications

Journal of Laparoendoscopic — Wed, 30 Nov 2011 19:58:19 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques Dec 2011, Vol. 21, No. 10: 983-986. (Source: Journal of Laparoendoscopic)

Percutaneous Transhepatic Gallbladder Drainage Changes Emergency Laparoscopic Cholecystectomy to an Elective Operation in Patients with Acute Cholecystitis

Journal of Laparoendoscopic — Wed, 30 Nov 2011 19:58:16 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques Dec 2011, Vol. 21, No. 10: 941-946. (Source: Journal of Laparoendoscopic)

Trocar-Site Hernia After Single-Port Cholecystectomy: Not an Exceptional Complication?

Journal of Laparoendoscopic — Wed, 30 Nov 2011 19:57:40 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques Dec 2011, Vol. 21, No. 10: 919-921. (Source: Journal of Laparoendoscopic)

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Percutaneous Cholecystostomy for Acute Cholecystitis: Ten-Year Experience

Journal of Vascular and Interventional Radiology : JVIR — Wed, 30 Nov 2011 05:00:00 +0100

Conclusions: Outcomes after percutaneous cholecystostomy for acute cholecystitis are better when the disease is primary and not precipitated by concurrent illness. (Source: Journal of Vascular and Interventional Radiology : JVIR)

Single-Incision Laparoscopic Cholecystectomy: Do Patients Care?

Journal of Gastrointestinal Surgery — Tue, 29 Nov 2011 22:21:54 +0100

Conclusion As single-incision cholecystectomy enlarges what is already a painful and undesirable incision, and since patients often do not recall the smaller incisions, we should ask ourselves whether surgeons and industry care more about this technique than do the patients to whom we offer it. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s11605-011-1785-2Authors Kalman P. Bencsath, Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, A100, 9500 Euclid Avenue, Cleveland, OH 44195, USAGavin Falk, Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, A100, 9500 Euclid Avenue, Cleveland, OH 44195, USAGareth Morris-Stiff, Department of General Surgery, Digestive Disease I...

Low Pressure Versus Standard Pressure Pneumoperitoneum in Laparoscopic Cholecystectomy

AORN Journal — Mon, 28 Nov 2011 15:06:36 +0100

What is the effect of using low pressure compared with standard pressure pneumoperitoneum during laparoscopic cholecystectomy? For keyhole removal of the gallbladder, an inert gas, usually carbon dioxide, is injected into the abdomen. Generally, a pressure of 12 mm Hg to 16 mm Hg is used for surgery. During insufflation of the abdomen, several physiological parameters change related to the heart and lung. Lowering the pressure might decrease cardiopulmonary complications and reduce postoperative pain; however, lower pressure may not provide a clear surgical field, which presents safety concerns. Although a clear surgical field is of importance during the surgical procedure, reduced cardiopulmonary complications, as well as reduced postoperative pain, use of analgesics, and shoulder pain w...

Gallbladder Lesions Identified on Ultrasound. Lessons from the Last 10 Years

Journal of Gastrointestinal Surgery — Wed, 23 Nov 2011 16:40:46 +0100

Conclusions Despite improvements in imaging, most apparent lesions measuring <5 mm on US are not identified in the surgical specimen. US size >9 mm, age >52 years, US suggestion of invasion at the liver interface, and wall thickening >5 mm, especially in the presence of gallstones, should raise the suspicion of malignancy. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s11605-011-1696-2Authors Ioannis T. Konstantinidis, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USASurabhi Bajpai, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USAAvinash R. Kambadakone, Department of Radiology, Massachusetts General Hospital a...

Early severe digestive complications after lung transplantation [Original articles]

European Journal of Cardio-Thoracic Surgery — Wed, 23 Nov 2011 05:00:00 +0100

Conclusion: ESDC occurred in 7.4% of patients after LT without CPB, and was responsible for longer in-hospital stay. Relevant risk factors included older age and bilateral LT, interfering with current debate regarding recipients’ selection and procedure's choice. (Source: European Journal of Cardio-Thoracic Surgery)

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Simultaneous large cell neuroendocrine carcinoma and adenocarcinoma of the stomach.

World Journal of Gastroenterology : WJG — Mon, 21 Nov 2011 05:00:00 +0100

Authors: Terada T, Maruo H Abstract A large cell neuroendocrine carcinoma (LCNEC) of the stomach is very rare. A 76-year-old Japanese man was admitted to our hospital because of epigastralgia and nausea. Endoscopy revealed 2 large tumors in the stomach. He did not have multiple endocrine neoplasia type I or Zollinger-Ellison syndrome. Imaging modalities, including computed tomography and magnetic resonance imaging, revealed no other tumors. Gastrectomy, cholecystectomy, and lymph node dissection were performed. The resected stomach had 2 tumors: one was an antral ulcerated type 3 tumor measuring 5 cm x 5 cm, and the other was a polypoid type 1 tumor measuring 6 cm x 6 cm x 3 cm in the fundus. Microscopically, the antral ulcerated tumor was a well differentiated adenocarcinoma w...

An Unusual Cause of Abdominal Pain in a 86-Year-Old Woman

Gastroenterology — Mon, 21 Nov 2011 05:00:00 +0100

Question: An 86-year-old woman was brought to the emergency department for right upper abdominal pain and fever for 3 days. Her medical history included hypertension and gastric cancer with Biliroth II gastrectomy and cholecystectomy 10 years previously. At admission, she was icteric, febrile, hypotensive (blood pressure, 64/44 mmHg), and tachycardic (pulse rate, 119 beats per minute). Laboratory examination revealed elevated white blood cell count of 10,800/mm3 with 57% of band form and total bilirubin of 2.03 mg/dL (normal, 0–1.2). Under the diagnosis of acute cholangitis, abdominal computed tomography (CT) was performed (, ). (Source: Gastroenterology)

Intravascular Large B-cell Lymphoma Presenting as Cholecystitis and Pancytopenia: Case Report with Literature Review.

Annals of Clinical and Laboratory Science — Fri, 18 Nov 2011 22:18:03 +0100

We report a recent case of IVLBCL presenting as acute cholecystitis and pancytopenia. The patient underwent a simple cholecystectomy. Examination of the gallbladder showed clusters of large lymphoma cells within lumina of small vessels in the gallbladder wall. These cells were positive for CD5/CD20 and negative for CD3, CD10, and TdT. Based on these findings, a diagnosis of IVLBCL was made. Coincidently, circulating lymphoma cells were identified in the peripheral blood and confirmed by flow cytometric analysis (positive for CD19/CD20/CD5, without light chain expression). The patient was started on chemotherapy but subsequently died of chemotherapy related multi-organ failure 10 days after the initial diagnosis. PMID: 22075510 [PubMed - in process] (Source: Annals of Clinical and Labor...

[Cholelithiasis in infants, children and adolescents.]

Presse Medicale — Fri, 18 Nov 2011 05:00:00 +0100

Authors: Debray D, Franchi-Abella S, Irtan S, Girard M Abstract The prevalence of cholelithiasis is estimated within 0.13% and 2% of children under 19 years of age. Pigment stones are the commonest type of gallstones in children, without recognizable predisposing factors in infants or secondary to a predisposing disease such as chronic hemolysis and ileal disease in children. In adolescents, idiopathic cholesterol gallstones accounts for the majority, such as in adults. Gallbladder stones are found in 80 to 90% of cases and common bile duct stones in 10 to 20% of cases. When common bile duct stones are found, a choledocal cyst with anomalous pancreatobiliary duct junction needs to be excluded. Magnetic resonance cholangiopancreatography should be performed in first line. Cholecyste...

Early cholecystectomy and ERCP are associated with reduced readmissions for acute biliary pancreatitis: a nationwide, population-based study

Gastrointestinal Endoscopy — Fri, 18 Nov 2011 05:00:00 +0100

Conclusion: Cholecystectomy and ERCP during the index admission were associated with reduced readmission rates for ABP, providing population-based evidence to support consensus guidelines that recommend early biliary intervention. (Source: Gastrointestinal Endoscopy)

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Short- and long-term outcomes following percutaneous cholecystostomy for acute cholecystitis in high-risk patients

Surgical Endoscopy — Thu, 17 Nov 2011 06:59:03 +0100

Conclusions Percutaneous cholecystostomy is an alternative to cholecystectomy in patients with acute calculous cholecystitis who are at high risk for surgical mortality and morbidity. It appears to have a low complication rate and good clinical success. Because a significant number of patients suffer recurrent attacks, elective cholecystectomy should be considered routinely. Unfortunately, firm criteria for selecting percutaneous cholecystostomy over cholecystectomy are lacking, and the surgeon’s clinical judgment is critically important. Content Type Journal ArticlePages 1-9DOI 10.1007/s00464-011-2035-0Authors Andrew McKay, Department of Surgery, Health Sciences Centre, University of Manitoba, GF-431, 820 Sherbrook Street, Winnipeg, MB R3A 1R9, CanadaMoaz Abulf...

[Gallstone disease: basic mechanisms, diagnosis and therapy].

Praxis — Wed, 16 Nov 2011 05:00:00 +0100

Authors: Casper M, Lammert F Abstract Gallstone disease is one of the most common gastroenterological diseases and represents a major burden for our heath care systems. Cholesterol gallstones, responsible for about 90% of stones, represent a multifactorial disease with an important genetic component. Most gallstone-carriers remain asymptomatic and hence in general, they not need any therapy. In contrast those with symptomatic (biliary colic) or complicated gallstone disease (cholecystitis, obstructive cholangitis, biliary pancreatitis) have to be treated interdisciplinarily by surgeons and endoscopists. Laparoscopic cholecystectomy represents the causal therapy to avoid recurrent symptoms as well as the therapy of choice for cholecystitis as the most common complication of gallston...

Repeated transvaginal notes: is it possible?

Surgical Endoscopy — Tue, 15 Nov 2011 07:18:32 +0100

Conclusions This report suggests that, in experienced hands, repeated TV access for extrapelvic surgery is possible and safe, putting forward the intriguing promises of less adhesions formation. Content Type Journal ArticleCategory VideoPages 1-1DOI 10.1007/s00464-011-1923-7Authors S. Perretta, IRCAD, Department of Digestive and Endocrine Surgery, University of Strasbourg, Strasbourg, FranceM. Vix, IRCAD, Department of Digestive and Endocrine Surgery, University of Strasbourg, Strasbourg, FranceB. Dallemagne, IRCAD, Department of Digestive and Endocrine Surgery, University of Strasbourg, Strasbourg, FranceJ. Nassif, IRCAD, Department of Gynecology and Obstetrics, University of Strasbourg, Strasbourg, FranceG. Donatelli, IRCAD, Department of Digestive and Endocrine Su...

Intermediate results of a prospective randomized controlled trial of traditional four-port laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy

Surgical Endoscopy — Tue, 15 Nov 2011 06:46:56 +0100

Conclusions In this multicenter randomized controlled trial of SILC versus 4PLC, SILC appears to be safe with a similar biliary complication profile. Pain scores and wound complication rates are higher for SILC; however, cosmesis scores favored SILC. For patients preferring a better cosmetic outcome and willing to accept possible increased postoperative pain, SILC offers a safe alternative to the standard 4PLC. Further follow-up is needed to detail the long-term risk of wound morbidities, including hernia recurrence. Content Type Journal ArticlePages 1-8DOI 10.1007/s00464-011-2028-zAuthors Melissa S. Phillips, Department of Surgery, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Ave., Lakeside 7, Mailstop 5047, Cleveland, OH...

Possible mortality reduction by endoscopic sphincterotomy during endoscopic retrograde cholangiopancreatography: a population-based case–control study

Surgical Endoscopy — Tue, 15 Nov 2011 06:46:56 +0100

Conclusions Old age and comorbidity are the main risk factors for death after ERCP, but a complex procedure or the occurrence of a complication also seems to increase short-term mortality. The performance of a sphincterotomy may reduce the risk of death, possibly by facilitating adequate drainage. A previous cholecystectomy also may decrease the risk of death after ERCP. Content Type Journal ArticlePages 1-8DOI 10.1007/s00464-011-2042-1Authors Cecilia Strömberg, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, SwedenUrban Arnelo, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, SwedenLars Enochsson, Department of Clinical Science, Intervention and Technology, Karolinska Inst...

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Single-stage treatment with intraoperative ERCP: management of patients with possible choledocholithiasis and gallbladder in situ in a non-tertiary Spanish hospital

Surgical Endoscopy — Tue, 15 Nov 2011 06:46:55 +0100

Conclusions Intraoperative ERCP is an option to prevent performing ERCP unnecessarily on patients with moderate risk of CLD not confirmed using appropriate radiological studies. It can resolve the biliary disease in a single step with a similar success rate to standard ERCP, but with low morbidity, especially of acute pancreatitis. The residual CLD rate is also very low. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-011-1990-9Authors L. R. Rábago, Gastroenterology Department, Hospital Severo Ochoa, Leganés, Madrid, SpainI. Chico, Gastroenterology Department, Hospital Severo Ochoa, Leganés, Madrid, SpainD. Collado, Gastroenterology Department, Hospital Severo Ochoa, Leganés, Madrid, SpainA. Olivares, Gastroenterology Department, Hospital Severo Ochoa, L...

Single-incision laparoscopic cholecystectomy using a modified dome-down approach with conventional laparoscopic instruments

Surgical Endoscopy — Tue, 15 Nov 2011 06:46:48 +0100

Conclusions SILC using a modified dome-down approach is technically feasible with all straight instruments, and it is safe because of good delineation of ductal anatomy. Adoption of this approach may minimize the risk of bile duct injury during early experience of SILC. Content Type Journal ArticleCategory Dynamic ManuscriptPages 1-7DOI 10.1007/s00464-011-1985-6Authors Hongyi Cui, Department of Surgery, University of Massachusetts Medical School, UMass Memorial Medical Center, 67 Belmont Street, Suite 201, Worcester, MA 01605, USAJohn J. Kelly, Department of Surgery, University of Massachusetts Medical School, UMass Memorial Medical Center, 67 Belmont Street, Suite 201, Worcester, MA 01605, USADemetrius E. M. Litwin, Department of Surgery, University of Massachusett...

Timing and Risk Factors of Hepatectomy in the Management of Complications Following Laparoscopic Cholecystectomy

Journal of Gastrointestinal Surgery — Wed, 09 Nov 2011 07:03:57 +0100

Conclusion Hepatectomy may inevitably be necessary to manage early or late complications after LC. Proximal BDI and VI were the two independent risk factors of hepatectomy in this series. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s11605-011-1769-2Authors J. Li, Department of General, Visceral and Transplantation Surgery, University Hospital Tübingen, Tübingen, GermanyA. Frilling, Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UKS. Nadalin, Department of General, Visceral and Transplantation Surgery, University Hospital Tübingen, Tübingen, GermanyC. E. Broelsch, Professor Emeritus, Sybelstr.26, 40239 Düsseldorf, GermanyM. Malago, Department of Surgery, University College London, Royal Free Ho...

Presence of concomitant inflammatory bowel disease is associated with an increased risk of postcholecystectomy complications

Inflammatory Bowel Diseases — Tue, 08 Nov 2011 05:00:00 +0100

Conclusions:IBD patients undergoing cholecystectomy have a significantly increased risk of postoperative complications. Although further studies are warranted to clarify the reason for these differences, caution should be taken to determine the need and timing of cholecystectomy in IBD patients. (Inflamm Bowel Dis 2011;) (Source: Inflammatory Bowel Diseases)

Association of dyslipidaemia with cholilithiasis and effect of cholecystectomy on the same

International Journal of Surgery — Mon, 07 Nov 2011 05:00:00 +0100

Conclusion: There was a significant decrease in plasma concentration of lipids in Cholecystectomy patients postoperatively. These changes in plasma lipids are likely to have significant effect in the development of coronary artery diseases in patients with Cholecystectomy.Highlights: ► Aim was to see the effect of cholecystectomy on dyslipidaemia. ► All patients underwent lipid profile before cholecystectomy. ► There was an improvement in lipid profile abnormality on day third of surgery. ► There was again improvement in lipid profile of the patients 6 months after surgery. (Source: International Journal of Surgery)

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Unusual Enhancing Foci

The American Journal of Medicine — Mon, 07 Nov 2011 05:00:00 +0100

Pressure to treat can discourage physicians from carrying out the careful investigations needed for correct diagnosis. Here, we describe a case in which the correct diagnosis took several years, and became apparent only after a review of patient records revealed a decade-old surgical history of laparoscopic cholecystectomy performed for acute calculous cholecystitis. (Source: The American Journal of Medicine)

Guidelines for the diagnosis and management of hereditary spherocytosis – 2011 update

British Journal of Haematology — Sat, 05 Nov 2011 04:00:00 +0100

SummaryGuidelines on hereditary spherocytosis (HS) published in 2004 (Bolton‐Maggs et al, 2004) are here replaced to reflect changes in current opinion on the surgical management, (particularly the indications for concomitant splenectomy with cholecystectomy in children with mild HS, and concomitant cholecystectomy with splenectomy in those with asymptomatic gallstones). Further potential long term hazards of splenectomy are now recognised. Advances have been made in our understanding of the biochemistry of the red cell membrane which underpins the choice of tests. Biochemical assays of membranes proteins and genetic analysis may be indicated (rarely) to diagnose atypical cases. The diagnostic value of the eosin‐5‐maleimide (EMA) binding test has been validated in a number of studies...

New methods for innovation: the development of a toolbox for natural orifice translumenal endoscopic surgery (NOTES) procedures

Surgical Endoscopy — Fri, 04 Nov 2011 05:43:50 +0100

Conclusions A new method for efficient medical device invention and development was created to address key technology needs for NOTES. The result was a “toolbox” of devices designed to address the key surgical activities necessary for advanced intralumenal and translumenal flexible endoscopic procedures. Content Type Journal ArticlePages 1-11DOI 10.1007/s00464-011-1987-4Authors C. Paul Swain, Department of Bio Surgery & Surgical Technology, Imperial College London, St. Mary’s Hospital, London, UKKurt Bally, Ethicon Endo-Surgery, Inc., Cincinnati, OH, USAPer-Ola Park, Department of Surgery, Södra Älvsborg Hospital, Borås, SwedenC. Alexander Mosse, Department of Bioengineering and Medical Physics, University College, London, UKRichard I. Rothstein, Section of...

Laparoscopic Cholecystectomy Without Handling the Cystic Artery: A New Approach to Minimize Complications

Journal of Laparoendoscopic — Wed, 02 Nov 2011 19:57:04 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

A randomised controlled pilot trial to evaluate and optimize the use of anti-platelet agents in the perioperative management in patients undergoing general and abdominal surgery—the APAP trial (ISRCTN45810007)

Langenbeck's Archives of Surgery — Wed, 02 Nov 2011 17:00:46 +0100

Conclusions Perioperative intake of ASA does not seem to influence the incidence of severe bleeding in non-high-risk patients undergoing elective general or abdominal surgery. Further, adequately powered trials are required to confirm the findings of this study. Content Type Journal ArticleCategory Controlled Clinical TrialPages 1-10DOI 10.1007/s00423-011-0867-7Authors D. Antolovic, Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, GermanyA. Rakow, Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, GermanyP. Contin, Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenh...

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Qualitative and quantitative analysis of women’s perceptions of transvaginal surgery

Surgical Endoscopy — Wed, 02 Nov 2011 05:48:29 +0100

Conclusions As in prior studies, scarring and pain were important issues to be considered, but recovery time and increased invasiveness were also in the “top five” list. The surveyed women appeared to actively participate in evaluating the technical components of the procedures. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-011-1984-7Authors Juliane Bingener, Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USAJeff A. Sloan, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USAKarthik Ghosh, Department of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USAAndrea McConico, Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USAAndrea Mariani, Department of Obstet...

Accidental Gallbladder Perforation During Laparoscopic Cholecystectomy: Does It Have an Effect on the Clinical Outcomes?

Journal of Laparoendoscopic — Tue, 01 Nov 2011 18:11:37 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Biliary Dyskinesia: How Effective is Cholecystectomy?

Journal of Gastrointestinal Surgery — Tue, 01 Nov 2011 05:53:23 +0100

Conclusion Cholecystectomy does not appear to be as effective for biliary dyskinesia when long-term follow-up is evaluated. Content Type Journal ArticleCategory 2011 SSAT Plenary PresentationPages 1-7DOI 10.1007/s11605-011-1742-0Authors Vikas Singhal, Department of Surgery, Guthrie-Robert Packer Hospital, 1 Guthrie Sq, Sayre, 18840 PA, USAPatrick Szeto, Department of Surgery, Guthrie-Robert Packer Hospital, 1 Guthrie Sq, Sayre, 18840 PA, USAHeather Norman, Department of Surgery, Guthrie-Robert Packer Hospital, 1 Guthrie Sq, Sayre, 18840 PA, USANan Walsh, Department of Surgery, Guthrie-Robert Packer Hospital, 1 Guthrie Sq, Sayre, 18840 PA, USABurt Cagir, Department of Surgery, Guthrie-Robert Packer Hospital, 1 Guthrie Sq, Sayre, 18840 PA, USAThomas J. VanderMeer, Departm...

Temporary placement of stent grafts in postsurgical benign biliary strictures: a single center experience.

Korean J Radiol — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSION: Treatment of benign biliary strictures with temporary placement of stent-grafts has a positive effect, but is less successful in patients with strictures developed following a liver transplant. PMID: 22043153 [PubMed - in process] (Source: Korean J Radiol)

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Laparoscopic cholecystectomy: Australian beginnings

ANZ Journal of Surgery — Tue, 01 Nov 2011 04:00:00 +0100

AbstractChance meetings in the USA and in France lead to the realization of the potential for cholecystectomy to be performed laparoscopically. Outlined are the steps taken to learn the technique and perform the first such operation in Australia (with unusual circumstances), immediately followed by the introduction of audit and training courses. Historical narrative. (Source: ANZ Journal of Surgery)

“Obama system:” A new easy, safe, and economical technique for laparoscopic single‐port surgery

Asian Journal of Endoscopic Surgery — Tue, 01 Nov 2011 04:00:00 +0100

ConclusionThe Obama system is easier to use and more efficient and reliable than any other technique currently available for LESS. This system is expected to greatly contribute to the further development and wider acceptance of LESS. (Source: Asian Journal of Endoscopic Surgery)

Lipid lowering drugs and gallstones: a therapeutic option?

Current Pharmaceutical Design — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Lioudaki E, Ganotakis ES, Mikhailidis DP Abstract Cholelithiasis is a common disease worldwide. The majority of gallstones can occur when the bile is supersaturated with cholesterol. Dyslipidaemia, obesity, insulin resistance are associated with an increased risk for cholesterol gallstone formation as well as with vascular risk. Statins and ezetimibe are used to treat dyslipidaemia and appear to have some effect on bile composition and cholesterol gallstone formation. Statin (e.g. pravastatin, simvastatin, fluvastatin and lovastatin) monotherapy or combined with ursodeoxycholic acid (UDCA) have shown reductions in bile cholesterol saturation, preventing gallstone formation and even dissolving pre-existing stones. However, this effect was not consistently reported in all st...

Endoclip migration into the duodenum: an unusual complication after laparoscopic cholecystectomy.

The American Surgeon — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Ray S, Bavishi Y PMID: 22196626 [PubMed - in process] (Source: The American Surgeon)

Laparoscopic type 7 total hysterectomy and adnexectomy with or without Burch colposuspension: operative technique with the LigaSure device and results

Archives of Gynecology and Obstetrics — Mon, 31 Oct 2011 16:47:47 +0100

Conclusion The procedure we describe here for type 7 TLH with adnexectomy, performed alone or with additional Burch colposuspension, appears to be safe and effective. Content Type Journal ArticleCategory General GynecologyPages 1-8DOI 10.1007/s00404-011-2123-3Authors Onder Surgit, Department of General Surgery, Fatih University School of Medicine, Alparslan Türkeş Caddesi No. 57, Emek, 06510 Ankara, TurkeyIlknur Inegol Gumus, Department of Obstetrics and Gynecology, Fatih University School of Medicine, Ankara, TurkeyAysel Derbent, Department of Obstetrics and Gynecology, Fatih University School of Medicine, Ankara, TurkeySerap Simavli, Department of Obstetrics and Gynecology, Fatih University School of Medicine, Ankara, Turkey Journal Archives of Gynecology ...

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Timing of Laparoscopic Cholecystectomy in Acute Cholecystitis: Any Controversy?

Surgical Practice — Mon, 31 Oct 2011 04:00:00 +0100

Conclusions Current evidence supports ELC as the preferred treatment strategy for acute cholecystitis. It allows a shorter hospital stay but shares similar operative morbidity, mortality and conversion rate as DLC. (Source: Surgical Practice)

Laparoscopic cholecystectomy in liver cirrhosis patients: An Egyptian experience

Surgical Practice — Mon, 31 Oct 2011 04:00:00 +0100

Conclusion: laparoscopic cholecystectomy is a safe procedure for hepatitis C positive cirrhotic patients when established risk stratifications systems such as CTP and MELD scores are used for evaluation. (Source: Surgical Practice)

Clinicopathologic features of advanced gallbladder cancer associated with adenomyomatosis

Virchows Archiv — Fri, 28 Oct 2011 17:17:37 +0100

Abstract Adenomyomatosis of the gallbladder has not been considered to have malignant potential, but gross features of adenomyomatosis are sometimes encountered in gallbladders resected under a diagnosis of gallbladder carcinoma. The purpose of this study was to determine the clinicopathologic features and survival rates in cases of gallbladder cancer with gross features of adenomyomatosis. The study subjects were 97 surgically treated gallbladder carcinoma patients. Only gallbladder showing typical gross features of adenomyomatosis was judged as adenomyomatosis-positive gallbladder cancer. In terms of gross findings, 25 cases (25.8%) were classified as adenomyomatosis-positive. The status of adenomyomatosis was significantly associated with the T stage (P = 0.0004), ly...

The changes of the Oddi Sphincter motilities in dog after cholecystectomy

Chinese Journal of Digestive Diseases — Fri, 28 Oct 2011 04:00:00 +0100

Conclusions: Shortly after cholecystectomy in Beagle dogs, the CBD pressure increased, SO motilities didn't change significantly during the interdigestive phase except a shortened cycle duration. Its relaxation responded to CCK was weakened with a confused contraction pattern. (Source: Chinese Journal of Digestive Diseases)

Robotic single-incision laparoscopic cholecystectomy

Journal of Robotic Surgery — Wed, 26 Oct 2011 10:46:18 +0100

Content Type Journal ArticleCategory Case ReportPages 1-2DOI 10.1007/s11701-011-0310-7Authors Philippe Morel, Division of Digestive Surgery, Department of Surgery, University Hospital Geneva, 4, Rue Gabrielle-Perret-Gentil, 1211 Geneva, SwitzerlandFrancois Pugin, Division of Digestive Surgery, Department of Surgery, University Hospital Geneva, 4, Rue Gabrielle-Perret-Gentil, 1211 Geneva, SwitzerlandPascal Bucher, Division of Digestive Surgery, Department of Surgery, University Hospital Geneva, 4, Rue Gabrielle-Perret-Gentil, 1211 Geneva, SwitzerlandNicolas C. Buchs, Division of Digestive Surgery, Department of Surgery, University Hospital Geneva, 4, Rue Gabrielle-Perret-Gentil, 1211 Geneva, SwitzerlandMonika E. Hagen, Division of Digestive Surgery, Department of Surgery, University Hos...

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Inflammatory pseudotumor of the liver in association with spilled gallstones 3 years after laparoscopic cholecystectomy: Report of a case

Asian Journal of Endoscopic Surgery — Sun, 23 Oct 2011 12:19:36 +0100

In conclusion, the liver tumor emerged after laparoscopic cholecystectomy and may involve inflammatory pseudotumor of the liver in association with spilled gallstones. (Source: Asian Journal of Endoscopic Surgery)

‘Extreme’ vasculobiliary injuries: association with fundus‐down cholecystectomy in severely inflamed gallbladders

HPB: official journal of the International Hepato Pancreat Biliary Association — Sun, 23 Oct 2011 04:00:00 +0100

Conclusions: Extreme vasculobiliary injuries tend to occur when fundus‐down cholecystectomy is performed in the presence of severe inflammation. Contractive inflammation thickens and shortens the cystic plate, making separation of the gallbladder from the liver hazardous. (Source: HPB: official journal of the International Hepato Pancreat Biliary Association)

Hepatobiliary and Pancreatic: Clip migration after laparoscopic cholecystectomy

Journal of Gastroenterology and Hepatology — Sat, 22 Oct 2011 09:58:07 +0100

(Source: Journal of Gastroenterology and Hepatology)

Natural orifice transluminal endoscopic surgery: New minimally invasive surgery come of age.

World Journal of Gastroenterology : WJG — Fri, 21 Oct 2011 04:00:00 +0100

Authors: Huang C, Huang RX, Qiu ZJ Abstract Although in the past two decades, laparoscopic surgery, considered as a great revolution in the minimally invasive surgery field, has undergone major development worldwide, another dramatic surgical revolution has quietly appeared in recent years. Ever since Kalloo's first report on transgastric peritoneoscopy in a porcine model in 2004, interest in a new surgical procedure named natural orifice transluminal endoscopic surgery (NOTES) has blossomed worldwide. Considering that a NOTES procedure could theoretically avoid any abdominal incision, operation-related pain and scarring, many surgeons and endoscopists have been enthusiastic in their study of this new technique. In recent years, several NOTES studies have been carried out on porcin...

The impact of body mass index on outcomes after laparoscopic cholecystectomy

Surgical Endoscopy — Thu, 20 Oct 2011 05:56:13 +0100

Conclusions Increased BMI was not associated with worse outcomes after LC. Compared with normal weight patients, obese and even morbidly obese patients have no increased risk of conversion to open surgery, nor is there an increased risk of perioperative complications. Obese and morbidly obese patients who require a cholecystectomy should be considered in the same category as normal weight patients, and LC should be the standard of care. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-011-1978-5Authors Daniel T. Farkas, Department of Surgery, Bronx-Lebanon Hospital, Albert Einstein College of Medicine, 1650 Selwyn Ave, Suite 4E, Bronx, NY 10457, USADovid Moradi, Department of Surgery, Bronx-Lebanon Hospital, Albert Einstein College of Medicine, 1650 Selwyn A...

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Surgeons provide definitive care to patients with gallstone pancreatitis

American Journal of Surgery — Thu, 20 Oct 2011 04:00:00 +0100

Conclusions: For patients with GP, admission to surgery results in definitive treatment with same-stay cholecystectomy. This is a more efficient approach with fewer readmissions for the same disease process. (Source: American Journal of Surgery)

Laparoscopic cholecystectomy as a teaching operation: comparison of outcome between residents and attending surgeons in 1,747 patients

Langenbeck's Archives of Surgery — Wed, 19 Oct 2011 15:51:09 +0100

Conclusions Provided adequate training, supervision and patient selection, surgical residents are able to perform LC with results comparable to those of experienced surgeons. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00423-011-0863-yAuthors René Fahrner, Department of Surgery, Spital Limmattal, 8952 Schlieren, SwitzerlandMatthias Turina, Department of Surgery, Spital Limmattal, 8952 Schlieren, SwitzerlandValentin Neuhaus, Department of Surgery, Spital Limmattal, 8952 Schlieren, SwitzerlandOthmar Schöb, Department of Surgery, Spital Limmattal, 8952 Schlieren, Switzerland Journal Langenbeck's Archives of SurgeryOnline ISSN 1435-2451Print ISSN 1435-2443 (Source: Langenbeck's Archives of Surgery)

Pronounced variation in bile acid synthesis in humans is related to gender, hypertriglyceridaemia and circulating levels of fibroblast growth factor 19

Journal of Internal Medicine — Wed, 19 Oct 2011 12:30:09 +0100

Conclusions: BA synthesis has a wide inter‐individual variation, is lower in women than in men, and is correlated positively with serum TGs. High BA production is frequently linked to hypertriglyceridaemia. Age‐related hypercholesterolaemia is not associated with changes in BA or cholesterol production, nor to an increase in cholesterol absorption. In humans, the circulating level of FGF19 may regulate hepatic BA production under fasting conditions. (Source: Journal of Internal Medicine)

Diagnosis and Treatment of Multiseptate Gallbladder with Recurrent Abdominal Pain

Diagnostic and Therapeutic Endoscopy — Wed, 19 Oct 2011 09:39:44 +0100

We present a 29-year-old female patient with multiseptate gallbladder, cholecystectomy was performed, and her abdominal pain and gastrointestinal complaints have resolved. (Source: Diagnostic and Therapeutic Endoscopy)

Pain Relief in Laparoscopic Cholecystectomy—A Review of the Current Options

Pain Practice — Wed, 19 Oct 2011 04:00:00 +0100

Abstract: Pain relief after laparoscopic cholecystectomy (LC) is an issue of great practical importance. Pain after LC has several origins: incisional, local visceral, peritoneal, and referred. Several modalities have been employed for achieving effective and safe analgesia: nonsteroidal anti‐inflammatory drugs (NSAIDs) and cyclooxygenase‐2 (COX‐2) inhibitors, gabapentinoids, local anesthetics, and transversus abdominis plane (TAP) block. They have their advantages and disadvantages, and multimodal approaches are often followed because of the multiple sources of pain. Among COX‐2 inhibitors, parecoxib and valdecoxib are useful, and fears regarding their cardiovascular adverse effects in noncardiac surgery (such as LC) have not been substantiated when used in short term. Gabapent...

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Cholecystectomy and risk of pancreatic cancer: a meta-analysis of observational studies

Cancer Causes and Control — Tue, 18 Oct 2011 15:57:44 +0100

Conclusions The results of this meta-analysis suggest that individuals with a history of cholecystectomy may have an increased risk of pancreatic cancer. Content Type Journal ArticleCategory Original paperPages 1-9DOI 10.1007/s10552-011-9856-yAuthors Genlai Lin, Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, ChinaZhaochong Zeng, Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, ChinaXiaolin Wang, Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032 ChinaZheng Wu, Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, ChinaJian Wang, Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, Ch...

ERCP and Endoscopic Sphincterotomy (ES): A Safe and Definitive Management of Gallstone Pancreatitis with the Gallbladder Left In Situ

Journal of Gastrointestinal Surgery — Tue, 18 Oct 2011 06:00:24 +0100

Conclusion ERCP with ES is a safe alternative to laparoscopic cholecystectomy to prevent further attacks of gallstone pancreatitis in high-risk surgical patients and the elderly. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s11605-011-1729-xAuthors Mark Bignell, Department of General Surgery, Norfolk and Norwich Hospital, Norwich, UKMatthew Dearing, Department of General Surgery, Norfolk and Norwich Hospital, Norwich, UKAndrew Hindmarsh, Department of General Surgery, Norfolk and Norwich Hospital, Norwich, UKMichael Rhodes, Department of General Surgery, Norfolk and Norwich Hospital, Norwich, UK Journal Journal of Gastrointestinal SurgeryOnline ISSN 1873-4626Print ISSN 1091-255X (Source: Journal of Gastrointestinal Surgery)

Single-Port Robotic Cholecystectomy: Results From a First Human Use Clinical Study of the New da Vinci Single-Site Surgical Platform [Original Article]

Archives of Surgery — Mon, 17 Oct 2011 04:00:00 +0100

Conclusion Robotic single-port cholecystectomy is feasible and comparable with standard laparoscopic cholecystectomy in the Veterans Administration medical center setting. (Source: Archives of Surgery)

Are We Making Progress?: Comment on "Single-Port Robotic Cholecystectomy" [Invited Critique]

Archives of Surgery — Mon, 17 Oct 2011 04:00:00 +0100

(Source: Archives of Surgery)

Reassessing the Need for Prophylactic Surgery in Patients With Porcelain Gallbladder: Case Series and Systematic Review of the Literature [Original Article]

Archives of Surgery — Mon, 17 Oct 2011 04:00:00 +0100

Conclusions Porcelain gallbladder is only weakly associated with GBC. Prophylactic cholecystectomy is not indicated for PGB alone and should be performed only in patients with conventional indications for cholecystectomy. A laparoscopic approach is appropriate for most patients with a PGB. (Source: Archives of Surgery)

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Fatal dengue hemorrhagic fever imported into Germany

Infection — Fri, 14 Oct 2011 15:43:25 +0100

Abstract Dengue virus (DENV) is an arthropod-borne virus (family Flaviviridae) causing dengue fever or dengue hemorrhagic fever. Here, we report the first fatal DENV infection imported into Germany. A female traveler was hospitalized with fever and abdominal pain after returning from Ecuador. Due to a suspected acute acalculous cholecystitis, cholecystectomy was performed. After cholecystectomy, severe spontaneous bleeding from the abdominal wound occurred and the patient died. Postmortem analysis of transudate and tissue demonstrated a DENV secondary infection of the patient and a gallbladder wall thickening (GBWT) due to an extensive edema. Content Type Journal ArticleCategory Case ReportPages 1-3DOI 10.1007/s15010-011-0208-3Authors J. Schmidt-Chanasit, Department o...

Gallbladder Surgery And Abdominal Pain

Health News from Medical News Today — Fri, 14 Oct 2011 08:00:00 +0100

According to a new study in Clinical Gastroenterology and Hepatology, better understanding of a patient's abdominal pain could help physicians know which patients will benefit most from surgical removal of the gallbladder. Clinical Gastroenterology and Hepatology is the official journal of the American Gastroenterological Association. Nearly 800,000 gallbladder removal surgeries, or cholecystectomies, are performed annually in the U.S. at a cost exceeding $6 billion... (Source: Health News from Medical News Today)

Regional lymphadenectomy strongly recommended in T1b gallbladder cancer.

World Journal of Gastroenterology : WJG — Fri, 14 Oct 2011 04:00:00 +0100

This article discusses the adequate treatment of early gallbladder cancer (T1a, T1b) and is based on published studies extending over nearly 3 decades. Randomized studies and meta analyses comparing different surgical treatments do not exist. The literature shows that in up to 20% of patients lymph node metastasis are found in T1b gallbladder cancer. Due to high malignancy with early angiolymphatic spread and resistance to chemotherapy and radiation on the one hand, and the relative low operative risk of extended cholecystectomy (cholecystectomy and regional lymphadenectomy) on the other hand, we believe that this procedure is mandatory in early gallbladder cancer. PMID: 22090793 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)

Metabolic response to abdominal surgery: The 2-wound model

Surgery — Fri, 14 Oct 2011 04:00:00 +0100

We would like to thank Dr Fujita for his interest regarding our recently published hypothesis on the metabolic response after abdominal surgery and the 2-wound model. The benefits of a single instillation of intraperitoneal local anesthetic (IPLA) on pain after laparoscopic cholecystectomy (small intraperitoneal wound), laparoscopic gastric surgery (larger intraperitoneal wound), and even laparotomy are known and have been shown by recent meta-analyses. Although individual clinical trials may have provided conflicting results, as mentioned by Dr Fujita, the benefits of IPLA in these settings are based upon cumulative data from more than 2,000 patients from 42 double blind randomized trials. (Source: Surgery)

α-Defensins and hsCRP levels in inflammatory response of standard and laparoendoscopic single-site cholecystectomy

Surgical Endoscopy — Thu, 13 Oct 2011 05:51:40 +0100

Conclusion Higher inflammatory reaction in LESS cholecystectomy could be the result of greater tension on the tissues. More studies are needed to conclude if this has a significant clinical expression. Content Type Journal ArticlePages 1-5DOI 10.1007/s00464-011-1921-9Authors Konstantinos E. Tsimogiannis, Department of Surgery, “G. Hatzikosta” General Hospital of Ioannina, Hippocratus 3, Stavraki, 45332 Ioannina, GreeceConstantinos C. Tellis, Biochemistry Lab, Department of Chemistry, University of Ioannina, Ioannina, GreeceAlexandros D. Tselepis, Biochemistry Lab, Department of Chemistry, University of Ioannina, Ioannina, GreeceGeorge Pappas-Gogos, Department of Surgery, “G. Hatzikosta” General Hospital of Ioannina, Hippocratus 3, Stavraki, 45332 Ioannina, Gr...

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Novel technique for biliary reconstruction using an isolated gastric tube with a vascularized pedicle: a live animal experimental study and the first clinical case.

Annals of Surgical Innovation and Research — Mon, 10 Oct 2011 04:00:00 +0100

Conclusion: In mongrel dogs, biliary reconstruction using pedicled gastric tube interposition between CBD and duodenum is feasible with satisfactory clinical results, anastomotic circumference and histological evidence of healing. The technique is also feasible in human and seems to be promising. (Source: Annals of Surgical Innovation and Research)

Acquisition of fundamental laparoscopic skills: Is a box really as good as a virtual reality trainer?

International Journal of Surgery — Mon, 10 Oct 2011 04:00:00 +0100

Conclusion: Both the VR and box trainer are effective in the acquisition of laparoscopic skills.Highlights: ► We compared the efficiency of training in laparoscopic skills on a Virtual Reality simulator with a traditional box trainer. ► Parameters were measured on a laparoscopic cholecystectomy on the VR trainer before and after training. ► Both groups showed improvement in all measured parameters with no statistically significant difference between the two groups. ► Both the VR and box trainer are effective in the acquisition of laparoscopic skills. (Source: International Journal of Surgery)

Torsion of the Gallbladder

Journal of Gastrointestinal Surgery — Sat, 08 Oct 2011 05:51:08 +0100

Conclusions Torsion of the gallbladder is a rare but clinically important condition in which the diagnosis seldom is made preoperatively. In radiological and clinical signs of cholecystitis without gallstones, this condition should be considered. Content Type Journal ArticleCategory GI ImagePages 1-3DOI 10.1007/s11605-011-1712-6Authors Elizabeth A. Boonstra, Department of Abdominal Surgery, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsBoudewijn van Etten, Department of Abdominal Surgery, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsTed R. Prins, Department of Radiology, University Medical Centre Groningen, Groningen, The NetherlandsEgbert Sieders, Department of Hepatobiliary Surgery and L...

Role of Kasai procedure in surgery of hilar bile duct strictures.

World Journal of Gastroenterology : WJG — Fri, 07 Oct 2011 04:00:00 +0100

CONCLUSION: The Kasai procedure combined with biliary stents may be appropriate for patients with hilar biliary stricture that cannot be managed by standard surgical methods. PMID: 22072856 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)